Chewing Tobacco(Smokeless Tobacco, Snuff)

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

What is chewing tobacco?

Chewing tobacco is sometimes known as chewing tobacco or spitting tobacco. It is available in two forms, snuff and chewing tobacco. Both types of
chewing tobacco are held in the mouth inside the cheek or between the cheek and gum. Snuff and chewing tobacco are commonly available in tins or pouches; popular brand names include Skoal and Copenhagen. Snus
(pronounced like "snoose") is a finely ground form of snuff that originated in Norway and Sweden that comes in small tins. The amount of snuff placed in the mouth is referred to as a pinch, dip, lipper, or quid. A portion of chewing tobacco is referred to as a plug, wad, or chew.

Chewing tobacco is known to contain at least 28 cancer-causing chemicals, medically known as carcinogens. The main carcinogens in
chewing tobacco are the tobacco-specific nitrosamines (TSNAs). Some of the other cancer-causing agents found in
chewing tobacco are formaldehyde, acetaldehyde, arsenic, benzopyrene, nickel, and cadmium. Many people mistakenly believed that snus is a safe form of
chewing tobacco because it is steam-heated rather than fermented when produced in Norway or Sweden, causing it to have fewer nitrosamines. However, snus still contains a number of cancer-causing chemicals. Snus made in America is not necessarily processed in the same way as in Norway or Sweden.

Nicotine is also found in snuff and chewing tobacco, like all tobacco products. Although nicotine is absorbed more slowly from
chewing tobacco than from cigarettes, 3 to 4 times more nicotine is absorbed from
chewing tobacco than from a cigarette, and the nicotine from chewing tobacco remains longer in the bloodstream. Nicotine is the substance responsible for tobacco addiction.

Chewing tobacco is not the same thing as chewing cigarettes. Chewing cigarettes (also termed e-cigarettes) are designed to provide nicotine in vapor to the user without burning tobacco. However, the smokeless cigarettes still provide addictive nicotine to the user and secondhand nicotine to others.

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Chewing Tobacco (Smokeless Tobacco, Snuff)

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